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Sex as Part of a Heart-Healthy Lifestyle

by Kait Scalisi | Sep 30, 2015 | News, Sex Stories

Generally speaking, sex is a good thing. It helps people de-stress, feel closer to their partners, and more. But those with heart disease or a history of heart attack often worry that sex might trigger another cardiac event. A new study says that’s not the case and that, for most, even those who’ve had a heart attack in the past, sex is part of a heart-healthy lifestyle.

For the most part, sex won’t trigger a heart attack.

The study aimed to shatter the myth that sex can trigger a heart attack. To do this, researchers reviewed the health histories of over 500 heart disease patients aged 30-70. Most participants were 50+ and male at baseline. The researchers sought to answer three main questions:

How long before their heart attack did participants have sex?
How often did they have sex in the 12 months before their heart attack?
Did they have another heart attack in the 10 years since the original one?

What they found is that less than 1% of the participants had sex within an hour of their heart attack. For a very large majority, there were more than 24 hours between sex and the heart attack. Additionally, most participants were having sex on a regular basis in the year before their heart attack without problem. More than half did it at least once a week while 74% reported having sex somewhere between once a week and once a month. Lastly, when researchers followed up with patients after 10 years, 100 cardiac events were reported. This was less likely if patients were younger, male, generally active, and in good health.

This data is heartening; however it is also lacking some important information. For example, how often did participants have sex during those 10 years? A lot can change in a decade, including participants’ ability to have vigorous sex. Other common life changes that could impact their sex lives during this time include loss of a spouse to death or divorce, having children, menopause, opening or closing a relationship, getting injured, and being diagnosed with other conditions.

It also did not measure participants’ knowledge about the relationship between sex and heart attack or their intent to change their sex lives in any way as a result of the heart attack. Given the pervasiveness of this myth, these additional questions would make the results both more generalization and more weighty.

Rather than triggering a heart attack, sex may actually be heart-healthy.

The study’s researchers classified it as a safe moderate activity, similar to brisk walking. Cardiologists often recommend this type of activity to heart disease patients alongside a heart-healthy diet and medicines. While the researchers don’t go so far as to recommend sex as part of the patient’s physical activity plan, they note that doing it is better than not:

…our data still indicate that the benefits of [sexual activity] outbalance the relatively small risk, especially because very few patients at risk could be easily identified by physical examination and stress testing.

Healthcare providers aren’t talking to their patients about sex.

The study also found that most patients–less than half of men and less than a third of women–don’t get information about sex after a heart attack from their healthcare provider. This mirrors the narrative in the US where healthcare providers don’t talk to patients about sex, regardless of the diagnoses. Undoubtedly, the lack of conversation about sex contributed to the misunderstandings about sex and heart attacks.This makes it especially important for cardiologist to reassure patients when they can resume sex and/or make the appropriate referrals to providers who specialize in sexual issues if needed.

The question behind the question.

According to one cardiologist interviewed by Newsweek, when patients ask about sex, they really want to know how much they can exert themselves. She also discusses the routine follow-up that heart patients often have after a heart attack, including regular stress tests. She says,

This can help a physician determine if certain levels of physical exertion could be life-threatening, whether it’s jogging, snow shoveling, chasing after grandkids or having sex. Source

What this perspective doesn’t take into account is the socioeconomic factors that may prevent someone from getting these regular checkups. While the researchers controlled for age, sex, education, rehabilitation program, smoking status, diabetes, HDL level, self-reported physical activity, and other health factors, they do not go into detail about how these factors impacted the outcomes.

We need a more nuanced look at the connection between sex and heart health.

The study adds to the body of research that currently exists around the connection between sex and heart attack risk. It tells us that, in general, sex won’t lead to heart attack. This supports past research showing that coital angina, or angina d’amour, represents less than half of all anginal attacks. Though angina doesn’t always lead to a heart attack, it’s one indicator.

Other factors could increase the risk of having a heart attack during or immediately after sex. These include:

Being mostly sedentary outside of sexual activity.
Other underlying health conditions including diabetes.
Having sex with a new or forbidden (e.g. mistress) partner.

Any of these could increase blood pressure and/or exertion level, making sudden cardiac death more likely. So while this study gives generally good news, it should absolutely be interpreted based on the individual patient’s health and lifestyle.

The final piece of info that could add a lot to the conversation is whether the length, intensity, and type(s) of sex matter. For example, are there additional risks for those who have more vigorous sex? How about folks who take part in certain BDSM sex acts? Answering these questions will let healthcare providers give more accurate and personalized information about sex and heart attack risk.

Other Sexual Health News This Week

Meta-analysis Supports Ovarian Suppression in Breast Cancer (Medscape)

High Standards of Care Associated with Reduced Mortality Risk of Patients with HIV (AidsMap)

Still Far to Go on Gender Equality Blueprint Set Out in 1995, Say Activists (The Guardian)

Women DO Want Sex as Much as Men and Most Orgasm Every Time (Daily Mail)

Sex Education Overhaul at Elite US Private Schools to Prevent Sexual Assault (ABC News)

The Value of Perseverance

by Kait Scalisi | Sep 15, 2015 | News, Sex Stories

To say Planned Parenthood has had a rough month is an understatement. Between heavily edited videos questioning the integrity of their services to renewed calls to defund the organization, it’s easy to undertand why the Congressional Budget Office commissioned a report to quantify the value of their services. The report sought to answer one question: where is Planned Parenthood the only option for low-cost family planning services?

The short answer: a lot of places.

The study used data from 2010, the most recent year it was available, and looked at a variety of factors including:

distribution of low-cost family planning centers
patient load
quality of services such as number of birth control options offered

The results of the study highlight the vital role that Planned Parenthood plays in providing low-income, medically-underseved communities with contraceptive services.

In many places, Planned Parenthood is the only option.

Nearly half of the organization’s health centers are in medically underserved areas. To break this down more:

Almost two-thirds of the 19 million women in need of publicly supported contraceptive services live in counties with a Planned Parenthood health center.
In 21% of the 491 counties with a Planned Parenthood center, they are the only safety-net family planning center.
In two-thirds of these counties, Planned Parenthood centers serve at least half of the patients who get birth control from such a health center.

To borrow a rather geeky phrase, Planned Parenthood boldly goes where no health center has gone (or perhaps stayed open) before.

Planned Parenthood serves a disproportionately high number of low-income patients.

Despite the fact Planned Parenthood centers only make up 10% of all safety-net family planning centers health centers, they serve over one-third of the patients who visit such clinics for contraceptive services. As Emily Crockett from RH Reality Check notes:

There may be more locations of other safety net family planning clinics than there are Planned Parenthood sites, but those clinics don’t serve nearly as many patients as Planned Parenthood does, and would likely be overwhelmed if their patient load suddenly surged. Source

Then of course there are the counties where there are no other clinics to serve this population. Defunding Planned Parenthood would leave nearly 100 counties access to any saftey-net family planning clinics. One can’t help but wonder what that would do to the current super low unexpected pregnancy rate.

The quality of service is practically unmatched.

Beyond the locations of Planned Parenthood health centers and the number of contraceptive patients the centers serve, the report also compared the quality of contraceptive services received at the different type of safety-net health centers. For this, researchers looked at number of birth control options available, the wait time, and the ability to get a same-day appointment.

Over 90% of the Planned Parenthood health centers offered at least 10 of 13 reversible contraceptive methods. Only about half of other sites could say the same. Additionally, wait times were three times shorter and patients were almost twice as likely to get a same-day appointment.

This means that patients are geting the services they need more quickly and able to choose the birth cntrol option that’s best for them. For low-income patients, especially hourly workers, these benefits are invaluble. s someone who’s both been on Medicaid and worked in a Meicaid contracpetive clinic, I can personally attest to the day-long waits, lost hours of work, and extra costs of childcare.

In many places, Planned Parenthood is critical to women’s reproductive health.

The data unequivoacally show that Planned Parenthood plays a major part in delivering contraceptive services to women in some of our nation’s most critically underserved areas. In some places it is the only option and in many others the centers serve many more contraceptive patients than other safety net providers.

At this point, we can only speculate what will happen to Planned Parenthood’s funding and how, if and when other center’s could fill the gaps left if they were to be defnded. What we do know though is this:

[…] women nationwide rely on Planned Parenthood health centers for the contraceptive services and supplies they need — and for women in many areas of the country, losing Planned Parenthood would mean losing their chosen provider and the only safety-net provider around. Source